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为慢性心肌缺血注射心内骨髓细胞:一项随机对照试验
Jan van Ramshorst1, Jeroen J Bax, Saskia L M A Beeres
1Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
JAMA
|May 21, 2009
概括
内心肌骨髓细胞注射在慢性心肌缺血症患者中适度改善了心肌 perfusion 和左心室功能. 需要进一步的研究来评估长期结果.
科学领域:
- 心脏病学 心脏病学
- 再生医学是一种再生医学.
- 临床试验 临床试验
背景情况:
- 之前的研究表明,骨髓细胞注射可能会在慢性心肌缺血症中增强心肌输液和左心室 (LV) 功能.
- 患有慢性心肌缺血症的患者往往有严重的症状,并且不符合常规再血管化的条件.
研究的目的:
- 评估心肌内髓骨髓细胞注射对慢性心肌缺血症患者心肌 perfusion 和 LV 功能的影响.
主要方法:
- 一个随机,双盲,安慰剂对照试验,涉及50名患有慢性心肌缺血症的患者.
- 患者通过心脏内注射接受了来自骨髓的自主单核细胞或安慰剂.
- 主要结局是心肌 perfusion 的总压力得分;次要结局包括 LV 喷射分数 (LVEF),心痛类和生活质量.
主要成果:
- 与安慰剂相比,注射骨髓细胞导致心肌输液 (总压力评分) 在统计学上显著改善.
- 在骨髓细胞组中观察到LV射出分数 (LVEF) 的适度增加.
- 接受骨髓细胞治疗的患者在加拿大心血管学会 (CCS) 胸痛类和生活质量得分中显著改善.
结论:
- 内心肌骨髓细胞注射在慢性心肌缺血症患者的心肌 perfusion 中提供了适度的短期益处.
- 该研究强调需要进一步研究长期疗效,死亡率和发病率的好处.
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